| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
209,978 |
162,847 |
$40.11M |
| 00003 |
Internal/system code - not a standard HCPCS code |
47,502 |
28,858 |
$9.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
215,824 |
160,687 |
$806K |
| 59425 |
|
14,620 |
9,276 |
$706K |
| 90834 |
Psychotherapy, 45 minutes with patient |
17,413 |
6,682 |
$544K |
| 98940 |
|
28,049 |
14,141 |
$277K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
14,153 |
11,932 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66,430 |
54,484 |
$181K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,694 |
7,666 |
$80K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,680 |
1,101 |
$72K |
| 97014 |
|
16,478 |
9,137 |
$71K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
3,976 |
2,252 |
$66K |
| V2020 |
Frames, purchases |
14,394 |
11,720 |
$54K |
| 90686 |
|
3,863 |
3,084 |
$49K |
| 99000 |
|
65,756 |
49,926 |
$43K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,862 |
742 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,838 |
6,459 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12,495 |
6,323 |
$38K |
| 90750 |
|
223 |
180 |
$36K |
| G9920 |
Screening performed and negative |
8,701 |
6,629 |
$35K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
3,545 |
1,619 |
$34K |
| 90791 |
Psychiatric diagnostic evaluation |
614 |
351 |
$33K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
47 |
43 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,354 |
5,445 |
$26K |
| 92015 |
Determination of refractive state |
18,397 |
14,900 |
$22K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,719 |
1,610 |
$22K |
| 59430 |
|
671 |
577 |
$21K |
| 99233 |
Prolong inpt eval add15 m |
492 |
339 |
$21K |
| 99401 |
|
1,371 |
981 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,730 |
5,999 |
$18K |
| 92551 |
|
24,820 |
18,892 |
$18K |
| 81025 |
|
8,645 |
7,058 |
$14K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
263 |
227 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,683 |
3,673 |
$13K |
| 90677 |
|
43 |
37 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
961 |
711 |
$13K |
| 96156 |
|
947 |
713 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,283 |
799 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,948 |
1,037 |
$10K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
414 |
338 |
$10K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
38 |
26 |
$9K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
209 |
151 |
$8K |
| 90746 |
|
130 |
102 |
$7K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
5,840 |
5,176 |
$7K |
| 0011A |
|
90 |
90 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
412 |
223 |
$6K |
| 97803 |
|
443 |
347 |
$6K |
| 97035 |
|
1,103 |
628 |
$6K |
| 0012A |
|
82 |
82 |
$5K |
| 59025 |
Fetal non-stress test |
322 |
102 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,880 |
4,274 |
$5K |
| 97032 |
|
726 |
439 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,607 |
7,365 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
867 |
497 |
$4K |
| 99215 |
Prolong outpt/office vis |
2,857 |
2,705 |
$4K |
| 11981 |
|
36 |
25 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,551 |
9,596 |
$4K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
15 |
15 |
$4K |
| 0001A |
|
52 |
52 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
62,734 |
52,446 |
$3K |
| 85018 |
|
59,747 |
46,747 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
41 |
36 |
$3K |
| 99403 |
|
67 |
67 |
$3K |
| 81003 |
|
3,570 |
2,860 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,748 |
4,606 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
32 |
26 |
$2K |
| 99381 |
|
199 |
165 |
$2K |
| 0002A |
|
37 |
37 |
$2K |
| 97802 |
|
193 |
153 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,099 |
1,747 |
$2K |
| 90715 |
|
92 |
69 |
$2K |
| 96151 |
|
181 |
129 |
$2K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
334 |
237 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,281 |
2,753 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
68 |
64 |
$2K |
| 11976 |
|
53 |
25 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
26 |
15 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,559 |
8,416 |
$2K |
| G9012 |
Other specified case management service not elsewhere classified |
53 |
41 |
$2K |
| 93000 |
|
322 |
231 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
250 |
250 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
30 |
25 |
$1K |
| J3490 |
Unclassified drugs |
52 |
50 |
$972.57 |
| 0072A |
|
16 |
15 |
$871.00 |
| 99460 |
|
27 |
26 |
$867.06 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
67 |
57 |
$782.34 |
| 99188 |
|
3,478 |
3,186 |
$748.80 |
| 99462 |
|
20 |
16 |
$636.52 |
| 87807 |
|
202 |
201 |
$565.40 |
| 0124A |
|
13 |
13 |
$520.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
27 |
25 |
$395.27 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
23 |
20 |
$355.59 |
| 96158 |
|
31 |
28 |
$319.58 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
34,019 |
17,088 |
$273.37 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
64 |
50 |
$178.84 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
38 |
24 |
$152.34 |
| 36415 |
Collection of venous blood by venipuncture |
20,142 |
18,724 |
$151.20 |
| 96150 |
|
14 |
12 |
$124.23 |
| 81002 |
|
1,306 |
1,045 |
$123.41 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
54 |
53 |
$87.36 |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
69 |
65 |
$84.96 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
230 |
171 |
$48.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
112 |
70 |
$44.51 |
| 82962 |
|
399 |
324 |
$18.89 |
| 88720 |
|
14 |
13 |
$15.48 |
| 86580 |
|
148 |
145 |
$11.42 |
| 99173 |
|
24,894 |
18,846 |
$5.06 |
| 96160 |
|
5,503 |
4,870 |
$4.20 |
| 87210 |
|
12 |
12 |
$3.56 |
| 1160F |
|
48,997 |
32,545 |
$0.00 |
| Z6400 |
|
806 |
719 |
$0.00 |
| 3078F |
|
12,119 |
10,843 |
$0.00 |
| 90473 |
|
2,748 |
2,008 |
$0.00 |
| 1159F |
|
48,995 |
32,545 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
269 |
257 |
$0.00 |
| 59426 |
|
816 |
474 |
$0.00 |
| 3077F |
|
1,854 |
1,327 |
$0.00 |
| Z6304 |
|
1,245 |
898 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
241 |
221 |
$0.00 |
| Z6300 |
|
154 |
154 |
$0.00 |
| Z6200 |
|
28 |
28 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
72 |
72 |
$0.00 |
| NOEM |
|
16 |
16 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
133 |
118 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
155 |
143 |
$0.00 |
| Z6308 |
|
32 |
24 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
73 |
73 |
$0.00 |
| Z6414 |
|
32 |
25 |
$0.00 |
| 69210 |
|
22 |
12 |
$0.00 |
| Z6208 |
|
29 |
26 |
$0.00 |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
19 |
12 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
12 |
12 |
$0.00 |
| 92134 |
|
12 |
12 |
$0.00 |
| Z6406 |
|
494 |
386 |
$0.00 |
| 36416 |
|
39,150 |
33,268 |
$0.00 |
| 3074F |
|
14,000 |
12,402 |
$0.00 |
| 3008F |
|
17,518 |
15,311 |
$0.00 |
| Z6410 |
|
2,693 |
1,493 |
$0.00 |
| 3075F |
|
1,511 |
1,453 |
$0.00 |
| 3079F |
|
4,502 |
4,251 |
$0.00 |
| 3080F |
|
813 |
678 |
$0.00 |
| Z1034 |
|
6,059 |
4,034 |
$0.00 |
| Z1038 |
|
287 |
266 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
222 |
222 |
$0.00 |
| Z6204 |
|
682 |
595 |
$0.00 |
| 96127 |
|
109 |
109 |
$0.00 |
| 1111F |
|
2,372 |
2,008 |
$0.00 |
| Z1032 |
|
330 |
329 |
$0.00 |
| 94760 |
|
169 |
115 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
496 |
199 |
$0.00 |
| Z6402 |
|
238 |
237 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
130 |
121 |
$0.00 |
| 90656 |
|
131 |
131 |
$0.00 |
| 96380 |
|
58 |
49 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| V2755 |
U-v lens, per lens |
36 |
12 |
$0.00 |